Depression can wear different clothes on different people. For me, depression wore anorexia and bulimia on and off again for about 10 years – and, boy, were they just jam-packed with self-loathing, isolation, and all sorts of other shenanigans!

Like that dude you drunk-texted one time who won’t lose your number, eating disorders don’t just go away on their own. You work and work and slowly get better and sometimes get worse before you get better again, and then one day you notice that you ate a donut and the world didn’t end.

Going Through It

There’s a popular children’s song called “We’re Going on a Bear Hunt” about (spoilers) some people going on a bear hunt together and encountering several obstacles on their path.

Uh-oh! A river, a cold, deep river.

We can’t go over it.

We can’t go under it.

We’ve got to go through it!

Like a river in your path, you can’t go over or under an eating disorder – you have to go (you guessed it) through it. But getting through it is easier with someone by your side.

When I was struggling with an eating disorder, I was lucky enough to have a best friend who, admittedly, had no idea what she was doing, but was brave and patient enough to stick it out with me.

It wasn’t easy for her, and it isn’t easy for anyone trying to help someone they love through an eating disorder. Anorexia has the highest mortality rate of any mental health disorder. So no pressure there.

And people dealing with eating disorders are typically pretty quiet about it. When you have an eating disorder, it becomes all you have and all you are. Giving up your secret means risking losing your security blanket, your identity, and your life’s purpose. So your ride-or-die might not be super enthusiastic about your help.

But picture them, a year or ten years from now, eating a donut, not worrying about the number of calories they’re consuming or what they’ll have to do to “work it off,” but, just, you know, living.

Recovery isn’t a gift you can give someone, but you can pitch in a few bucks.

How to Support Someone with an Eating Disorder

1. Listen

The cult joke about becoming a therapist is that it takes years of school to learn these two phrases: “How does that make you feel?” and “Hmm…” Obviously, a therapist’s job is not that cut and dry. But here’s the takeaway: Listen, first.

Nothing you can say will be as meaningful or helpful as the simple action of actively and empathetically listening to someone who is struggling.

What does that look like in practice? If someone does the hard work of letting you know that they’re struggling, sit back and let them take the lead. Ask them questions. Learn. Try this phrase: “What do you need from me right now?” If you care about someone, it’s natural to want to solve someone’s problems for them. Especially when the “solution” seems as simple as well, maybe you could just stop throwing up after meals? If it were actually that easy, they would have done it already.

Don’t worry about trying to fix their life for them. Don’t try to develop a treatment program for them based on a midnight Google search. Just listen and see where it leads you.

2. Be a Friend, First

It’s easy to let your friend’s eating disorder take over your friendship. But don’t let it become a third wheel. What do I mean? Feel free to check in with your friend about how they’re doing. Let them vent to you about their eating disorder or ask for support (if they want). But your friend is a person, not the product of their problems.

When you’re knee-deep in an eating disorder, you start to feel like that’s all you are – you’re not Allie, who likes history documentaries, parkour, and watercolor painting, you’re an Anorexic.

If you want to help, remember this: You’re not friends with an Anorexic, you’re friends with Allie, who has anorexia (and likes history documentaries, parkour, and watercolor painting). Talk about the same stuff you talked about before. See if they’re up for the activities you used to like to do together, or try to find other ways to spend time together while they’re struggling. Treat them like a person, not a patient.

3. Be Realistic

TV shows like to pretend that eating disorders, and the people who have them, are cute little projects for martyrs to take on. On TV, eating disorders can be developed and cured within twenty-five minutes. TV, of course, is full of bullshit. On TV, there’s always a magic word that fixes everything. Or the person with the eating disorder has a rock-bottom experience, sees the light, and snaps out of it.

Eating disorder recovery in the real world is 100% possible, but there’s no quick and simple fix.80% of people seeking treatment for eating disorders do recover, but it can take seven to ten years to get there (and sometimes longer). So, statistically speaking, your friend will probably be dealing with this for a while. One of the best things you can do to support them is to take the pressure off.

Celebrate the “small” successes – but only if your friend brings them up first. Some of the worst things to hear during eating disorder recovery are those well-meaning statements from friends and family, like, “You look so healthy!” or, “You cleared your plate last night – good job!” When you’re in recovery, “healthy” (usually) = “fat” and “cleared your plate” is not a compliment.

To be safe, avoid commenting on someone’s weight or food intake, even if you mean it in a positive way. You can still congratulate them for setting up a meeting with a therapist or for making plans to visit a support group (or whatever).

It’s worth saying again: Recovery is working and working and getting better, and sometimes getting worse, until, one day, you notice that things are, somehow, finally, better.

4. Treat Their Triggers Like a Bad Ex

For years, I would relapse pretty much anytime someone mentioned how little they had eaten that day or how they had lost weight recently. “I’ve only had a coffee and half a yogurt today” would turn into a challenge to eat less than they had.

The food I had already eaten that day (you know, for survival and whatnot) would transform into a boulder in my stomach, a reminder that I had failed (at starving myself to death), and I would get back on the wagon (to disordered eating and psychological pain). That other person – the one thriving on just a coffee and half a yogurt – would promptly forget the conversation ever happened, head out to Starbucks, and grab a latte and a sandwich, never the wiser.

I won’t pretend triggers are logical, or that the response to them is reasonable, but they are real and they can cause damage. No one expects you to be perfect when you’re talking to someone who has an eating disorder. But it’s worth it to have a conversation about what someone’s triggers are and try to avoid them while you’re with that person.

Some common triggers during eating disorder recovery are:

Comments about food intake – how much or little, how “good” or “bad” (i.e. “junk food” vs. “healthy food”)

Comments about weight, weight change, or body type

Comments about the relationship between food and weight (“Bread makes you fat”)

People can have all these triggers, some of them, none of them, or something totally different altogether. The best thing you can do is sit down with your friend andhave an honest conversation about what words or environments make the recovery process more difficult for them. Don’t expect to be perfect, but do have the courage to ask them to call you out if you say or do something that makes them uncomfortable. Then try again.

Recovery is a learning curve for everyone involved.

5. Be Prepared

I’ll say it again: Your job here is to be a friend. These tips will help you support someone dealing with an eating disorder, but they won’t save their life if they really need professional help. You can’t (and shouldn’t) force someone into treatment. Frothing at the mouth with helplines or your therapist’s contact information probably won’t win anyone over unless they’ve already decided they want to get help. But you can be ready with the information you need in case they do want to seek help.

It’s up to the person struggling to decide if, when, and how to get help (assuming they’re 18+), but knowing where to start – who to call or what website to check out first – can help make the process a little easier for them.

Post-Recovery: The 30-Second Epilogue

If you’re reading this, thank you for doing the hard work of trying to help someone who needs you. I was lucky enough to have my best friend wade through the cold, deep river with me, and I’m closing in on four years free from an eating disorder. It’s been four years since I cried over the number of calories in a scoop of ice cream. It’s been four years since I forced myself to throw up after every meal.

More importantly, over the past four years, I’ve graduated from college, adopted a dog, moved out on my own, been promoted (twice), traveled across the country, and quit drinking (again). And every donut over the past four years? – guilt-fucking-free.

I hope this guide helps you feel confident supporting someone through an eating disorder, and I hope you feel hopeful. With help, 80% of people recover from eating disorders. And the struggle is so, so worth it.